A newborn presents with delayed meconium passage, abdominal distension, and bilious vomiting. What is the most concerning diagnosis?

Correct Answer: C

Rationale: In this scenario, the most concerning diagnosis for a newborn presenting with delayed meconium passage, abdominal distension, and bilious vomiting is Hirschsprung disease (Option C). Hirschsprung disease is a congenital condition where there is a lack of ganglion cells in the distal colon, leading to functional obstruction. The rationale for why Hirschsprung disease is the correct answer lies in the classic presentation of symptoms such as delayed passage of meconium, abdominal distension due to the blocked colon, and bilious vomiting, which are indicative of a significant obstruction in the bowel. Regarding the other options: - A) Meconium plug syndrome: While it can cause bowel obstruction in newborns, it typically presents with a different clinical picture and does not involve the absence of ganglion cells. - B) Cystic fibrosis: Although it can present with gastrointestinal symptoms, it is less likely to cause the specific combination of symptoms described in the question. - D) Malrotation with volvulus: This condition involves a twisting of the bowel, which can lead to similar symptoms, but the absence of ganglion cells, as seen in Hirschsprung disease, is not a feature of malrotation. Educationally, understanding the differentiation between these conditions is crucial for pediatric nurses as it guides their clinical reasoning and decision-making in assessing and managing newborns with gastrointestinal symptoms. Recognizing the red flags for Hirschsprung disease can prompt timely interventions and prevent complications associated with this condition.

Correct Answer: C

Rationale: In pediatric nursing, understanding croup is crucial as it is a common condition. The correct answer is C) Incidence is higher in females. This statement is false as croup affects males and females equally. The most common organism causing croup is the parainfluenza virus, making option A correct. Option B is true as the peak age group affected by croup is between 6 months to 3 years. Option D is also accurate as a family history of croup may increase the likelihood of a child developing the condition. Educationally, knowing the typical characteristics of croup helps nurses provide effective care and education to parents. By understanding the common causes, age groups affected, and family history implications, healthcare professionals can better assess, diagnose, and manage croup cases. This knowledge also aids in differentiating croup from other respiratory conditions in pediatric patients, ensuring appropriate treatment and interventions are implemented promptly.

Correct Answer: A

Rationale: In this question, the incorrect statement regarding corticosteroids in allergy is option A) The mechanism of action is not known. The correct answer is A because the mechanism of action of corticosteroids is well understood. Corticosteroids act by suppressing the immune response, reducing inflammation, and inhibiting the release of inflammatory mediators. Option B) Corticosteroids are lymphopenic is incorrect because corticosteroids actually cause an increase in the number of circulating lymphocytes due to their immunosuppressive effects. Option C) Corticosteroids decrease synthesis of prostaglandins is incorrect because corticosteroids do not directly inhibit prostaglandin synthesis. They work by inhibiting the enzyme phospholipase A2, which leads to a cascade of anti-inflammatory effects. Option D) Long-term usage suppresses linear growth in children is incorrect because while long-term corticosteroid use can have adverse effects on growth in children, it primarily affects bone growth rather than linear growth specifically. Educationally, understanding the correct and incorrect statements about corticosteroids in allergies is crucial for pediatric nurses. It helps in providing appropriate care to pediatric patients with allergies, ensuring safe and effective management of their conditions. Nurses need to be knowledgeable about the mechanisms of action and potential side effects of corticosteroids to deliver quality care to pediatric patients.

Correct Answer: D

Rationale: In this question, the correct answer is D) Early sepsis. Distributive shock is a type of shock characterized by widespread vasodilation leading to decreased systemic vascular resistance. Early sepsis can cause distributive shock through the release of inflammatory mediators that trigger vasodilation and capillary leak. Option A) Cardiac tamponade is a type of obstructive shock where fluid accumulates in the pericardial sac, compressing the heart and preventing proper filling. This does not cause distributive shock. Option B) Dehydration is a type of hypovolemic shock resulting from decreased circulating blood volume, not from widespread vasodilation seen in distributive shock. Option C) Aortic stenosis is a type of obstructive shock caused by narrowing of the aortic valve, leading to decreased cardiac output. This does not result in distributive shock. Understanding the types and causes of shock is crucial in pediatric nursing as it helps nurses recognize early signs, intervene promptly, and provide appropriate care to stabilize the child's condition. Recognizing distributive shock, such as in early sepsis, is especially important as it requires specific interventions like fluid resuscitation and antibiotic therapy to address the underlying infection. By mastering these concepts, pediatric nurses can improve patient outcomes and provide high-quality care to pediatric patients in critical conditions.

Correct Answer: C

Rationale: In cases of bicarbonate loss in urine, the compensatory mechanism that takes place to keep the pH normal is hyperventilation. This is the correct answer because when bicarbonate is lost, leading to metabolic acidosis, the body compensates by increasing respiratory rate to blow off carbon dioxide (CO2), which helps to decrease the acidity in the blood and maintain a normal pH. Option A, extracellular shift of potassium, is incorrect because it is not a compensatory mechanism for bicarbonate loss in urine. Potassium shifts can occur in conditions like hyperkalemia but are not directly related to acid-base balance. Option B, hyperchloremia, is also incorrect as it refers to an increased level of chloride in the blood and is not a compensatory mechanism for bicarbonate loss. Option D, loss of organic acid in urine, is incorrect as it does not directly address the issue of bicarbonate loss and its impact on acid-base balance. Understanding the compensatory mechanisms in acid-base imbalances is crucial in pediatric nursing as it allows healthcare providers to assess and manage these conditions effectively. Knowing how the body responds to maintain homeostasis helps in providing appropriate interventions and improving patient outcomes.